CMR Right Ventricular Contractile Reserve Following Lung Resection
Assessment of Right Ventricular Contractile Reserve Following Lung Resection by Dobutamine Stress Cardiac Magnetic Resonance: a Feasibility Study
Belfast Health and Social Care Trust
42 participants
Jul 21, 2023
OBSERVATIONAL
Conditions
Summary
Feasibility study investigating CMR dobutamine stress testing before and after lung resection
Eligibility
Inclusion Criteria4
- \) Provision of informed consent 2) Age \>16 years 3) Planned elective
- lobectomy lung resection or
- oesophagectomy surgery with one lung ventilation or
- gastrectomy
Exclusion Criteria10
- Pregnancy
- On-going participation in any investigational research which could undermine the scientific basis of the study
- Atrial fibrillation at baseline
- Any contraindication to
- a. CMR, i. Cardiac pacemaker, artificial heart valve, neurostimulator, cochlear implant ii. Aneurysm clips iii. Metal injuries to the eye iv. Loose metal in a part of the body b. Dobutamine stress testing as per the Society for Cardiovascular Magnetic Resonance64 i. Severe systemic arterial hypertension (≥220/120 mmHg) ii. Unstable angina pectoris iii. Severe aortic valve stenosis (peak aortic valve gradient \>60mmHg or aortic valve area \< 1cm2) iv. Complex cardiac arrhythmias including uncontrolled atrial fibrillation v. Hypertrophic obstructive cardiomyopathy vi. Myocarditis, endocarditis, or pericarditis vii. Uncontrolled heart failure
- Lung resection specific
- Wedge, segmental or sub-lobar lung resection
- Pneumonectomy
- Isolated right middle lobectomy
- \-
Interventions
Dobutamine stress testing will be undertaken in keeping with local departmental clinical guidelines with a graded increase in dobutamine infusion up to a maximum of 10microgram/kg/min. The patients' medications will be managed in keeping with the usual clinical practice and departmental guidelines. At rest and on each graded level of dobutamine infusion we will collect cine loops of the cardiac cycle including a short-axis stack of the ventricles, a four-chamber view and flow imaging perpendicular to the main, left and right pulmonary arteries. Post-processing will be dual reported by blinded observers using the Argus analysis software (Siemens) according to a standardised protocol. A safety report of each CMR scan will be generated by a consultant cardiologist, any abnormalities identified will be referred to the appropriate medical speciality and highlighted to the patient's clinical team.
blood samples will be collected pre-operatively, in recovery, on post-operative days 1 and 2, and at 4-8 weeks post-operatively
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06465277